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Show Poster 30 Bilateral Sequential Central Vision Loss in a Young Man Samuel Thomsen1, Bokkwan Jun1 University of Missouri - Columbia, Columbia, Missouri, USA 1 Introduction: To report a case of bilateral sequential central vision loss and review possible etiologies. Methods: A 19-year-old right handed man who was previously healthy presented with a month history of blurry vision in the right eye. The visual disturbance was described as painless, no change over time. The patient had no history of recent contact to sick person or exposure to animals and no vaccination. The initial exam showed visual acuity was CF in the right eye and 20/20 in the left eye, dyschromatopsia in both eyes, central scotoma in the right eye on HVF and Amsler test and showed no RAPD, no optic disc swelling or no macula edema in either eye. MRI brain and orbit with and without contrast with fat suppression and serologic test including mitochondrial genome were performed. MRI was unremarkable. Coenzyme Q10 was started. About 5 weeks later, the patient returned to clinic with two-week history of blurry vision in the left eye which was described as sudden, painless, no change over time. The exam showed visual acuity was 5/100 in the right eye and 10/200 in the left eye, worsening dyschromatopsia, central scotoma in both eyes on HVF and Amsler test and showed mild disc edema in the left eye. FA showed telangiectatic vessels on both optic discs with no leakage or no staining. ONH OCT showed slight thickening of RNFL in both eyes at their early presentation. Systemic corticosteroid was administered with IVMP followed by oral prednisone tapering with no improvement. Mitochondrial genome analysis returned as negative for mutation but we considered repeating mitochondrial genome test. Results: See "Methods" Conclusions: The patient had bilateral optic neuropathy with clinical presentation of LHON without mutation of mitochondrial genome which is rare. We reviewed literatures and discussed other possibilities of bilateral sequential central vision loss in a young patient. References: None. Keywords: Optic neuropathy, Genetic Disease, Neuro-ophth & systyemic disease ( eg. MS, MG, thyroid), Visual fields Financial Disclosures: The authors had no disclosures. Grant Support: None. 2017 Annual Meeting Syllabus | 85 |
